Dong H, Xie L, Tang C, Chen S, Liu Q, Zhang Q, Zheng W, Zheng Z, Zhang H
Cancer Research Center, Shantou University Medical College, Shantou, China.
Clin Transl Oncol. 2014 Sep;16(9):783-91. doi: 10.1007/s12094-013-1149-3. Epub 2013 Dec 20.
The poor prognosis of gastroesophageal junction (GEJ) adenocarcinoma is largely associated with metastasis. We here report the first study to investigate the expression of epithelial-mesenchymal transition (EMT) markers Snail1 and E-cadherin in GEJ adenocarcinoma.
Snail1 and E-cadherin were detected by immunohistochemistry in a cohort of 128 patients with surgically resected GEJ adenocarcinoma. We assessed the pathologic and prognostic relevance in all patients and within clinically different preserved E-cadherin and reduced E-cadherin-expressing sub-groups.
Immunoreactivity for Snail1 and E-cadherin was positive in 68 and 43 % of tumors, respectively. Snail1-positive tumors had more frequent lymph node metastasis and advanced tumor stage. E-cadherin expression was highly associated with histological differentiation, tumor size, advanced stage, presence of lymph node metastasis and distant metastasis. Patients with positive E-cadherin expression or negative Snail1 expression had significantly favorable overall survival rate. In E-cadherin-preserved tumors, the expression of Snail1 was related to lymph node metastasis, advanced stage and poor patient outcome. However, Snail1 expression had no statistically significant relationship with clinicopathologic parameters or prognosis in the reduced E-cadherin-expressing sub-group. Multivariate survival analysis identified that tumor stage [hazard ratio (HR) 2.440; 95 % confidence interval (CI) 1.216-4.896; P = 0.012], lymph node metastasis (HR 2.404; 95 % CI 1.188-4.867; P = 0.015) and gender (HR 3.244; 95 % CI 1.568-6.714; P = 0.002) were independent prognostic markers for overall survival.
Snail1 may act more critically in E-cadherin-positive tumors. Evaluation of Snail1 and E-cadherin in GEJ adenocarcinoma may help in assessing malignant properties and stratifying patients.
胃食管交界部（GEJ）腺癌预后较差，很大程度上与转移有关。我们在此报告首项研究，旨在探究上皮-间质转化（EMT）标志物Snail1和E-钙黏蛋白在GEJ腺癌中的表达情况。
采用免疫组化法检测128例接受手术切除的GEJ腺癌患者队列中的Snail1和E-钙黏蛋白。我们评估了所有患者以及临床上不同的E-钙黏蛋白表达保留和表达降低亚组中的病理及预后相关性。
Snail1和E-钙黏蛋白的免疫反应性在肿瘤中的阳性率分别为68%和43%。Snail1阳性肿瘤的淋巴结转移更频繁，肿瘤分期更高。E-钙黏蛋白表达与组织学分化、肿瘤大小、晚期、淋巴结转移及远处转移高度相关。E-钙黏蛋白表达阳性或Snail1表达阴性的患者总体生存率显著更高。在E-钙黏蛋白表达保留的肿瘤中，Snail1的表达与淋巴结转移、晚期及患者预后不良有关。然而，在E-钙黏蛋白表达降低的亚组中，Snail1表达与临床病理参数或预后无统计学显著关系。多因素生存分析确定肿瘤分期[风险比（HR）2.440；95%置信区间（CI）1.216 - 4.896；P = 0.012]、淋巴结转移（HR 2.404；95% CI 1.18
